Platelet reactivity and activated clotting time predict hemorrhagic site complications in patients with chronic coronary syndromes undergoing percutaneous coronary interventions.

Background: Radial access is preferred in patients with chronic coronary syndromes (CCSs) treated with ad hoc percutaneous coronary intervention (PCI). Antithrombotic and antiplatelet treatment before PCI may affect outcomes at vascular access sites. QuikClot Radial is a kaolin-based band that may shorten hemostasis time.

Well-palpable pulse over an occluded radial artery: A case series reporting ultrasound outcomes.

We report a case series of four patients with radial artery occlusion complicating vascular access who were scheduled for coronary angiography. We describe the challenges in selecting adequate vascular access in patients with a history of coronary angiography and percutaneous coronary intervention, as well as the benefits of using preprocedural ultrasound examination of forearm arteries to detect radial artery occlusion. Our case series suggests that if the anterior interosseous artery provides partial blood supply to the hand as a collateral circulation of the occluded radial artery, the transulnar approach may be an alternative safe option for coronary angiography and percutaneous coronary intervention in this population.

The Impact of Using a Larger Forearm Artery for Percutaneous Coronary Interventions on Hand Strength: A Randomized Controlled Trial.

(1) Background: The exact mechanism underlying hand strength reduction (HSR) after coronary angiography with transradial access (TRA) or transulnar access (TUA) remains unknown. (2) Methods: This study aimed to assess the impact of using a larger or smaller forearm artery access on the incidence of HSR at 30-day follow-up. This was a prospective randomized trial including patients referred for elective coronary angiography or percutaneous coronary intervention.

TransRadial versus transUlnar artery approach for elective invasive percutaneous coronary interventions: a randomized trial on the feasibility and safety with ultrasonographic outcome - RAUL study.

Introduction: Transradial access (TRA) for coronary angiography (CAG) and percutaneous coronary intervention (PCI) is superior to transfemoral access (TFA). Transulnar access (TUA) is an alternative to TRA.

Aim: To compare the efficacy and safety of TRA vs.

Impact of the Use of a Larger Forearm Artery on the Efficacy and Safety of Transradial and Transulnar Access: A Randomized Trial with Preprocedural Ultrasonography.

(1) Background: We aimed to assess the impact of the selection of a larger radial or ulnar artery on the efficacy of access and vascular complications, based on preprocedural ultrasonographic examination. (2) Methods: This prospective, randomized trial included patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI). Patients were randomized into either a larger ulnar artery (UA) or radial artery (RA) group or smaller UA/RA group.

Efficacy and safety of kaolin-based hemostatic pad vs. standard mechanical compression following transradial and transulnar access for elective coronary angiography and PCI: RAUL trial substudy.

Hemostatic devices used in the transradial approach (TRA) and transulnar approach (TUA) are limited. This study compared the efficacy and safety of hemostasis using the QuikClot Radial hemostatic pad (QC) vs. standard mechanical compression (SC) after coronary angiography (CAG).

Iatrogenic Arteriovenous Fistula and Atrial Septal Defect Following Cryoballoon Ablation for Atrial Fibrillation - Two Correctable Causes of Right Heart Failure.

BACKGROUND Catheter ablation for atrial fibrillation is an important therapeutic intervention. One of the most frequent complications of this procedure is vascular issues including arteriovenous fistula. Iatrogenic atrial septal defect (IASD) has been reported as a complication of transseptal puncture; however, no data are available demonstrating any coexistent of arteriovenous fistula with IASD.

A novel technique for iatrogenic pseudoaneurysm obliteration with ultrasound-guided thrombin foam injection.

Background: Iatrogenic pseudoaneurysms (IPA) are treated with ultrasound-guided thrombin injections (UGTI). We describe a novel technique for IPA repair that applies UGTI with thrombin foam (UGTFI).

Methods And Results: Successful obliteration of 6 IPAs (IPA without a neck, n = 5; with a neck, n = 1) in 6 patients (2 males, aged 68 ± 1 years, 4 females, aged 59 ± 11 years) was performed by using UGTFI.

Acute Hemodynamic and Tissue Effects of Cryoballoon Ablation on Pulmonary Vessels: The IVUS-Cryo Study.

Background: Cryoballoon-based pulmonary vein isolation (CB-PVI) has been widely used for the treatment of atrial fibrillation. Although generally safe and effective, the procedure may be associated with pulmonary vein (PV) stenosis and bronchial or esophageal injury. The mechanisms leading to these complications have not been studied in detail.

Cryoballoon ablation for atrial fibrillation - is cryoenergy applied only to the pulmonary vein ostium?

This case report shows that cryoablation of pulmonary veins (PV) may occasionally result in deeper lesions than expected and collateral damage in spite of proper ostial positioning of cryoballoon. The use of intracardiac vascular ultrasound and repeated computed tomography enabled detailed examination of these findings.

Subarachnoid haemorrhage imitating acute coronary syndrome as a cause of out-of-hospital cardiac arrest - case report.

Background: Severe subarachnoid haemorrhage (SAH) is a common cause of cardiac arrest. The survival of patients with out-of-hospital cardiac arrest (OHCA) due to SAH is extremely poor. Electrocardiographic and echocardiographic changes associated with SAH may mimic changes caused by acute coronary syndromes (ACS) and thus lead to delayed treatment of the primary disease.

Noninvasive assessment of endothelial function and vascular parameters in patients with familial and nonfamilial hypercholesterolemia.

Introduction: Endothelial dysfunction is one of the markers of atherosclerosis.

Objectives: The aim of the study was to evaluate endothelial function by assessing flow-mediated dilation (FMD) and to measure the parameters of brachial arterial stiffness in patients with familial hypercholesterolemia (FH) and those with high low-density lipoprotein (LDL) cholesterol levels without FH mutations (nonfamilial hypercholesterolemia - non-FH).

Patients And Methods: The study involved 60 patients (mean age, 41.

Assessment of the prognostic value of coronary angiography in patients with non-ST segment elevation myocardial infarction.

Background: Management of patients with acute non-ST segment elevation myocardial infarction (NSTEMI) depends on risk evaluation. The recommended approach involves the use of risk stratification tools such as TIMI and GRACE risk scores. However, these clinical scores do not include variables derived from coronary angiography which is currently performed in most patients.

Efficacy and safety of closing postcatheterisation pseudoaneurysms with ultrasound-guided thrombin injections using two approaches: bolus versus slow injection. A prospective randomised trial.

Background: Thrombin injection is a widely accepted treatment of an iatrogenic arterial pseudoaneurysm. However, the optimal mode of injection and type of pseudoaneurysm amenable to this therapy have yet been established.

Aim: To compare efficacy and safety of two approaches to ultrasound-guided thrombin injections into a femoral artery pseudoaneurysm with or without long neck that developed as an iatrogenic complication of cardiac catheterisation.

Intermittent claudication caused by frequent premature ventricular complexes: resolution after radiofrequency ablation.

A case of a 55-year-old woman with psoriasis and long-lasting history of typical intermittent claudication associated with frequent premature ventricular complexes is reported. Atherosclerotic and nonarterial pathologic conditions were taken into consideration and were excluded. Applying 6-minute walk test and resting and peak-exercise pulsed Doppler ultrasonography, it was possible to prove a decrease in perfusion during exercise-persistent ventricular bigeminy.